It's not a case of who is better...

... but it will end up in a case of who gets hurt. I feel like the discussion about "sides" in the midwifery discussion is falling on deaf ears. I don't think - at least to my reading - that anyone is saying CNMs are evil. I haven't heard anyone saying CNMs lack book learning and clinical experience. I don't believe there is any doubt that CPMs have less experience in higher-risk births as they know when to risk those women out of their care.

The thought process that has me so puzzled, though, is the idea that midwives need to have a more standardized education - more "street cred" to their practice - in order to be taken seriously by the medical profession. This quote in particular (from navelgazing midwife quoting kneelingwoman) bothers me:

We cannot continue to practice in isolation from the rest of the health care system while insisting that they include us! Midwifery is not an island and it most certainly is not some maternal paradise where all women are safe and welcome!

1) Who is insinuating that midwives are insisting on inclusion in the health care system? Many of us are seeking out midwives who know themselves and their skill well enough to know they AREN'T in the health care system. We aren't looking for a medical birth at home. We're looking for someone to stand along side us while we go through another normal - NON-MEDICAL - phase of our lives... of our womanhood.

2) I know that I would turn on my heel if my midwife were to tell me she could guarantee my safety and that of my child - that without a doubt or second thought she would be at my side and in my home 9 months from now for my child's birth. No one can predict that kind of safety because LIFE HAPPENS!

I've had two beautiful, wonderfully memorable hospital births. I had a care provider - a family practitioner - at my side from positive test to baby's first breath and beyond. But walking through a pregnancy with someone with a medical degree is no better assumption of safety than doing so with a midwife - CNM or CPM. There seems to be this overriding idea that having that middle initial change will let midwives risk IN more women - how? I was told from day one that there would be certain things that would put me in need of finding an OB for the pregnancies - things that my MD couldn't do by law or wouldn't feel comfortable doing by oath.

I would expect the same of anyone walking through a pregnancy journey with me. The thing is, if there is a next time... I want something better! I want something personal and something that isn't kept within the confines of the medical model. Why? Because I have seen in myself and in my children's births that it doesn't have to be FOR ME. It doesn't have to be a medical event for EVERY WOMAN. Does it ever have to be? Sure! If something came up along the way (wacky blood pressure, crazy fetal heart tones, pre-e to name a few) would I expect to keep my home birth dream? Not at all. I would expect my midwife would tell me that it just isn't safe for me or my child to stay home - and I can't begin to think of one who would let me stay home under her care! Does having a nursing degree remove that need for responsibility to the mother? Does it make risk-taking a little more comfortable because there's a college degree backing your care?

I've heard it said as I've been following this "debate" that being or becoming a CNM opens care for more women - different needs, backgrounds, economics, social classes, educational backgrounds, etc. But by "exposing" the "lack of education" that DEMs/CPMs enter with into their profession, all that is being done is eliminating the route of non-medicalized birth that so many of us seek. Gather in new people that weren't served by midwifery in the past... and shove out the ones that were.

I hope, in the end, it's worth it.